An intuitive surgical handle design for robotic neurosurgery

Area of Science:

• Neurosurgery
• Robotics
• Surgical Instrumentation

Background:

• The expanded endoscopic endonasal approach (EEA) is a keyhole brain surgery technique offering access to the pituitary gland and surrounding areas.
• Navigating constrained nasal and sphenoid cavities with rigid instruments presents significant technical challenges for surgeons.

Purpose of the Study:

• To develop and present an intuitive handheld robotic instrument handle prototype designed to enhance surgeon capabilities in EEA.
• To address the technical challenges and improve ergonomics associated with manipulating instruments in confined surgical spaces.

Main Methods:

• A surgical instrument handle prototype was designed and fabricated, mapping surgeon wrist movements directly to robot joints.
• The prototype was mounted on the surgeon's forearm to mitigate wrist strain and fatigue, aligning it with the instrument shaft.
• A surgical task simulator was used to compare the novel handle's performance against a standard neurosurgical tool, with tasks executed by a consultant neurosurgeon.

Main Results:

• The surgeon achieved a higher average success rate using the proposed handle compared to the conventional tool.
• The Rapid Upper Limb Assessment (RULA) ergonomic survey indicated acceptable surgeon body posture with the prototype.
• Preliminary findings suggest no significant learning curve associated with the novel handle.

Conclusions:

• The developed handle prototype shows potential for improving current neurosurgical tools and procedural ergonomics.
• By transferring procedural forces to the surgeon's forearm and enabling intuitive wrist-to-robot joint mapping, the handle enhances the robotic end effector's workspace.
• This innovation represents a significant advancement toward improved neurosurgical instrumentation.